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I'm manic, do you mind?

The pressure to feel happy at Christmas can make students feel lonely and isolated.

Olga Wojtas finds out how university staff are being taught greater awareness in dealing with mental illness, from stress to self-destruction

Chris O'Sullivan, a biomedical science student at Aberdeen University, has manic depression. As the executive committee member of the Scottish National Union of Students with responsibility for students with disabilities, he is open about his disability, and insists the key to fighting the stigma still surrounding mental illness is greater awareness.

The higher education funding councils have taken a lead in encouraging institutions to develop a strategy for students with disabilities, including mental health problems.

"But while there are very clear strategies for students with MS, dyslexia or mobility impairment, there's not a clear enough picture of what will happen if they declare a mental illness," says Mr O'Sullivan.

He was undergoing treatment before going to Aberdeen, and sought a referral to a local psychiatrist who provides support and advice. But Barbara Waters, director of Skill, the national bureau for students with disabilities, says many students first disclose their illness to a tutor.

"We need to educate (staff) to feel confident about responding to this and knowing where to turn."

Skill has a mental health special interest group which includes higher education staff, and it produces a leaflet advising how to deal with students with mental health problems.

Interim findings from a major survey undertaken by Leicester University confirm that 54 per cent of students seeking help contact personal tutors, second only to the 65 per cent who talk to friends and family. The survey of second-year undergraduates is part of a three-year student psychological health project funded by the Higher Education Funding Council for England, and surveyed a broad range rather than a potentially atypical group who had sought medical help or counselling.

Project leader Annie Grant, director of Leicester's educational development and support centre, said: "It's very easy to survey people who seek help. But you have to ask whether students are not seeking help because they don't perceive it as appropriate, they don't know about it, or they've got their own very effective means of help and advice which we can learn from."

She believes the findings would be broadly typical of higher education institutions. Some 58 per cent of students worried about "severely inadequate finances", while 48 per cent were highly stressed or distracted by lack of self-esteem and confidence, 40 per cent by coping with sadness, depression or mood changes, and 23 per cent by managing anxieties, phobias or panic attacks.

"We want to raise understanding of what the stresses and strains are to ensure there are robust ways to reduce these. Staff development is a major aspect of this," says Dr Grant.

"If the overall climate is less stressful for everybody, those for whom the stress is the last straw will benefit. I have a very strong view that disability is not just a welfare issue, but there has to be a more holistic approach from the institution."

No statistics are available nationally on mental health problems among students, and how students compare with the general public. The Higher Education Statistics Agency figures for 1996-97 show only 546 students out of around 625,000 declaring that they have a mental health difficulty. But this only highlights the ongoing fear of disclosing such problems: while one in four people will develop problems at some point, the proportion is likely to be higher among students, since many people have their first episode of mental illness between the ages of 18 and 25.

"I also believe we are talking of an upward spiral because so many young people are in a pressure-cooker environment. Never have the strains of student life been as apparent as in these days of hardship, debt and stress," Mr O'Sullivan says.

One student health service survey shows that more than 15 per cent of students coming to the surgery had mental health problems, and around 11 per cent of students visiting the health service each year needed anti-depressants.

"Institutions are often acutely aware of how serious the threat of mental illness is in student life," says Mr O'Sullivan.

"That said, they often appear slow to respond to the difficulties and crises faced by students with mental illness. It is high time that institutions replace awkward discussion with effective support when it comes to addressing this issue."

Suicide is traditionally acknowledged as a problem in higher education, but it is a taboo subject, never openly addressed, Mr O'Sullivan says.

"Suicide is a subject that turns heads. Unfortunately, these heads usually turn away from the problem. Students at their lowest ebb, considering suicide, should be able to reach out and find help, rather than stumble about in darkness, with sometimes fatal consequences. There is no excuse for a student in the United Kingdom to die through a lack of support that could so easily be provided."

Edinburgh University has launched a unique initiative in the wake of a suicide and several attempted suicides in its halls of residence. The university accommodation services have linked up in a two-year pilot project with Barony Care Services, a professional voluntary sector agency, which offers home-based support.

"Our flat managers are professionally qualified, but not in the field of mental health," says housing officer Jan Gardiner.

"We want to try to raise awareness and discourage people from taking on too much themselves when they're not equipped to deal with it."

Fellow students often try to help a friend with mental health problems without seeking qualified help. But this can exacerbate difficulties when they themselves have to cope with essay crises or broken relationships, "abandoning" the friend who feels even more isolated.

Ms Gardiner says: "I think there are far more pressures on students these days. A lot feel they can't fail because their parents are forking out a huge amount of money. More and more are holding at least one part-time job.They perhaps force themselves into subject areas where they're not particularly comfortable, but they think will get them the best job at the end of the day."

"There are no statistics on this, but I wonder how many students have dropped out over the last ten years because they couldn't cope. If there had just been someone there to ease them through that period, they might have stayed."

* Skill can be contacted Monday to Friday on 0800 328 5050 between 1.30pm and 4.30pm.

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